ICD-10: Defeat the deadline

Whether you are at the early stages or in the home stretch of ICD-10 preparations, here are some strategies to be prepared.

With less than three months remaining until the conversion to the ICD-10 coding system, your planning should be well under way. Whether you are at the early stages or in the home stretch, here are some strategies to be prepared for October 1, 2015.

The first step, according to experts, is to stay calm. “Yes, it’s a big deal and a big change,” says consultant Mary Pat Whaley, FACMPE, CPC, “but it’s doable.”

Based on results from an exclusive poll conducted by Medical Economics, many physicians remain unprepared for the transition, and concerned about the impact on their practice’s finances and workflow. According to the poll results, only 38% of physicians surveyed said their practice will be ready by the October deadline, and 65% of those surveyed believe ICD-10 should be delayed again. (See complete results on page 27.)

Yet such a delay looks increasingly unlikely, so with no further ado, here are the five key areas your team is more than ready to tackle this summer.

Physician readiness

In most small or independent medical practices, physicians are likely selecting their own diagnosis codes for ICD-9 and will continue to do so for ICD-10. There is significant benefit to having coding happen as close to the point of origin as possible, meaning that the person who provides the care is usually best suited to code the encounter, says Whaley. However, clinicians who do their own coding may need more preparation than those who don’t.

Fortunately, physicians needn’t worry about memorizing all 68,000 codes or poring over every chapter of the codebook. Instead, experts recommend focusing on just the 50 to 100 codes a physician will use on a regular basis.

To do so, create a list of the top ICD-9 codes used in the practice, by provider, for the past 12 months, and compile a list of corresponding ICD-10 codes. While there are a few codes that are the one-to-one equivalent of each other, most ICD-9 codes will have multiple, more specific, ICD-10 codes with which to become familiar.

Once you narrow down the codes you’ll focus on, you can create tools such as cheat sheets, or load pick lists into your software to help physicians. Multiple training modalities exist, from webinars to on-site consulting to having your internal coders meet with doctors. Regardless of your approach, it’s important to keep physician training as focused and relevant to a physician’s particular practice as possible, says physician coding educator Betsy Nicoletti, MS, CPC. “Don’t purchase a huge training program that goes chapter by chapter. That’s deadly for doctors. They just want to know about the codes they need to know about,” she says.

But if you haven’t yet begun this process, beware of waiting much longer, she adds, noting that August is a popular vacation month. “Also remember that people don’t hear everything the first time, and that you probably will want time to repeat the training you’re doing for your clinicians.”

Finally, whether or not physicians do their own coding, it’s essential that they learn to document sufficiently to support the more granular diagnosis codes. To do so, doctors should get in the habit of including the phrases “due to” or “manifestation of” in their notes, says Whaley.

“There’s no question that staff are not going to be able to choose the code if the documentation doesn’t reveal the level of specificity of ICD-10, whereas in ICD-9 things were much more broadly categorized,” Whaley says. “If it’s not in the documentation, no coder is going to be able to read the physician’s mind and figure out what really went on during that visit and what the diagnosis is going to be.”

Nevertheless, it can be a challenge for practice managers and administrators to persuade doctors to take time away from patient care to learn ICD-10 and its documentation requirements. When meeting such resistance, remind physicians that coding snags will directly impact their profitability, suggests Kathy McCoy, MBA, a health IT blogger and social media contributor with experience in the electronic health records industry.

In addition, remind them of the long-term value of the conversion. “The goal of ICD-10 is to help population management by being better able to track diseases and diagnoses, so appeal to the physicians’ concerns that it will ultimately help patients,” McCoy says.

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